血清组织蛋白酶K在骨质疏松症诊断中的应用

摘要

Objective To investigate the levels of serum cathepsin K(Cathe K) in osteoporosis diagnosis. Methods Bone mineral densities of lumbar spine and femoral neck were measured by dual energy X-ray. According to bone mineral densities,187 objects were classified into 63 cases of bone loss and 124 cases of osteoporosis. In osteoporosis group,32 cases' drug treatment efficacy was monitored. A total of 142 healthy subjects were enrolled as healthy control group. Enzyme-linked immunosorbent assay was used to determine serum Cathe K and tartrate-resistant acid phosphatase(TRAP)levels. The levels of osteocalcin(N-MID),beta-collagen degradation product(β-crosslaps) and type Ⅰ procollagen N-terminal propeptide(PⅠNP)were determined by electrochemiluminescence immunoassay. According to ages,objects were classified into 35-45,46-55,56-65, 66-70 and ≥71-year-old groups. Results For 35-45,46-55 and 56-65-year-old groups,the levels of serum Cathe K in osteoporosis group were higher than those in healthy control group(P<0.01),but there was no statistical significance for 66-70 and ≥71-year-old groups between osteoporosis and healthy control groups (P>0.05). For 35-45-year-old group,the level of serum Cathe K in bone loss group was higher than that in healthy control group(P<0.01),and there was no statistical significance for the other age groups(P>0.05). In the analysis of bone turnover markers for 45-65-year-old groups,the levels of serum Cathe K,PⅠNP,β-crosslaps,N-MID and TRAP in osteoporosis group were higher than those in bone loss and healthy control groups(P<0.05). There was no statistical significance between bone loss and healthy control groups(P>0.05). Serum β-crosslaps and Cathe K decreased in osteoporosis group after treatment for 3 months(P<0.05). Conclusions Serum Cathe K can be used in the diagnosis and treatment monitoring of osteoporosis.%目的：探讨血清组织蛋白酶K（Cathe K）在骨质疏松症中的应用价值及意义。方法采用双能X线骨密度仪测定受检者腰椎及股骨颈的骨密度，根据骨密度值将187例受检者分为骨量减少组63例、骨质疏松症组124例。骨质疏松症组中有32例女性患者接受药物疗效监测。另选取体检者142名作为正常对照组。采用酶联免疫吸附试验（ELISA）检测所有受检者血清Cathe K、抗酒石酸酸性磷酸酶（TRAP）水平；同时采用电化学发光法检测骨钙素（N-MID）、β-胶原降解产物（β-crosslaps）、Ⅰ型前胶原氨基端前肽（PⅠNP）水平。各组按年龄再分为35～45岁组、46～55岁组、56～65岁组、66～70岁组、≥71岁组。结果骨质疏松症组35～45、46～55和56～65岁3个年龄段血清Cathe K水平均明显高于正常对照组同年龄段（P<0.01），而66～70及≥71岁与正常对照组同年龄段比较差异均无统计学意义（P>0.05）。骨量减少组血清Cathe K水平除35～45岁与正常对照组同年龄段相比明显增高（P<0.01）外，其余各年龄段与正常对照组同年龄段比较差异均无统计学意义（P>0.05）。对各组46~65岁人群的骨转换标志物进行分析，骨质疏松症组血清Cathe K、PⅠNP、β-crosslaps、N-MID、TRAP水平与骨量减少组及正常对照组比较差异均有统计学意义（P<0.05）；而骨量减少组与正常对照组之间各项指标差异均无统计学意义（P>0.05）。骨质疏松症患者按治疗方案治疗3个月后，血清β-crosslaps、Cathe K明显低于治疗前（P<0.05）。结论血清Cathe K可用于骨质疏松症的诊断及疗效观察。